Saturday, November 26

Bronchiolitis, what is this infection that occurs in minors?

With the arrival of the month of November, the respiratory syncytial virus (RSV), the main cause of bronchiolitis and the first reason for hospitalization of children under two years of age.

We are in one of the most propitious seasons of the year, and after two years of a pandemic in which it seemed that this and other flu viruses were under control, now it is once again recovering its usual presence.

In Spain, the incidence of this virus has passed in the last four weeks from 14 cases per 100,000 inhabitants to 45 casesespecially in children under four years of age, according to the latest report of the Acute Respiratory Infection Surveillance System (SIVIRA) of the Carlos III Health Institute and the National Epidemiological Surveillance Network.

A disease that behaves in the form of an epidemic during this time has arrived earlier and with more force. It is not more serious this year, but it has a particularity: is affecting children born during the pandemic and that, therefore, they are not used to the virus.

So much so that the Spanish Society of Pediatric Emergencies (SEUP) has expressed concern and uncertainty about the unexpected increase in the volume of care in pediatric emergencies in Spain in recent months. According to experts, in some emergencies up to a 40% more cases than in the pre-pandemic era.

What is bronchiolitis

bronchiolitis is a viral infection that occurs mainly in children under the age of two (although it also affects adults) and that it is caused, in addition to the respiratory syncytial virus (RSV), by others such as rhinovirus, adenovirus, influenza or metapneumovirus, among others.

These viruses, when they attack adults, are limited to a common cold. But in children, the virus attacks not only the nose and throat, but it can go down to the bronchi and cause inflammation and obstruction, causing coughing and respiratory distress.

This happens because the bronchi and bronchioles become inflamed. These tubes leave the trachea and through them air circulates to the lungs. Inflammation causes the wall of these tubes to thicken, narrow, and increases the risk of mucus buildup. All this makes it difficult for air to enter and exit the lungs.

Contagion occurs through the mucus or saliva of an infected person. Therefore, it spreads easily among family members, in nurseries or hospital wards.

What are the symptoms of bronchiolitis

The symptoms of bronchiolitis can be various. The Spanish Association of Primary Care Pediatrics (AEPap) lists the following signs as the most common:

  • Runny nose, mild cough, and fever: are the initial symptoms, of the first days, and are similar to those of a cold.
  • Heavier breathing and more coughing: It usually appears after two or three days.
  • Difficulty breathing: This problem is usually detected when we observe and see that the ribs are marked and the abdomen moves a lot, all accompanied by noises in the chest (wheezing or “whistling”).

Parents should be alert and go to the doctor or hospital in case of warning signs such as:

  • High fever
  • Very sleepy or irritable child
  • Increased breathlessness (greater sinking of the chest)
  • pauses in breathing
  • repeated vomiting

These symptoms are more common in infants and children under two years of age, since they are the ones with the smallest airways and, therefore, the ones that are most easily obstructed. Over the years, and as you get older, RSV infection usually becomes milder, similar to a cold.

What is the treatment for bronchiolitis?

This infection is not treated with antibiotics because it is caused by a virus (antibiotics only work against bacterial infections). Therefore, and as with other viral infections, most cases tend to heal on their own. seven or ten daysits natural course.

However, some mild symptoms such as coughing may last between two and four weeks.

There are certain general cares that will help alleviate the symptoms. The most used and effective are:

  • antithermal in case of fever in those older than three months.
  • fluid intakewater or milk, regularly, in small doses, throughout the day.
  • nasal washes with saline solution or saline solutions to clear the nose.
  • Ingestion of small and frequent amounts soft foods, since loss of appetite is common.
  • Avoid tobacco smoke.
  • Maintain good hygiene.
  • Avoid contact with people who have symptoms such as runny nose or cough.

The use of bronchodilators It has not been shown to have a beneficial effect, nor have corticosteroids, nor have cough syrups and mucolytics. In most cases, affected children evolve favorably, although some may require hospital admission.

How can we distinguish bronchiolitis from a common cold?

The bronchiolitis virus differs from a common cold in that it does not live alone in the upper respiratory tract (nose, paranasal passages, throat and larynx, eyes and ears) but down to the bronchi and causes inflammation and obstruction of these.

Unlike a simple cold, the signs that give us clues that it is something else are agitated breathing, breathing sinking the ribs and raising the abdomen (a sign that there is difficulty breathing), the child is very listless and apathetic and continuous coughing fits.

It is very difficult to prevent a cold from becoming bronchiolitis, beyond keeping the nose clean if there is congestion and good hydration.

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